Individual provider Active NPI

Monty Owen, PT

  • Physical Therapist
  • Mesa, AZ
National Provider Identifier
1609948090
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2989 Issued in AZ
Practice address
4323 E Broadway Rd
Suite 106
Mesa, AZ 85206-3506
Phone
(480) 854-9833
Fax
(480) 854-9834
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2989 AZ Primary

Addresses

Primary practice location

4323 E Broadway Rd
Suite 106
Mesa, AZ 85206-3506

Mailing address

1823 S Essex Cir
Mesa, AZ 85209-4015
Phone (480) 415-0744

Other identifiers 1

IdentifierTypeStateIssuer
AZ0297810OtherAZBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051102001071 AZ Practitioner - Physical Therapist in Private Practice 4880612431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4323 E Broadway Rd
Suite 106
Mesa, AZ 85206-3506
Phone (480) 854-9833

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2989AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Monty Owen Physical Therapy, LLC Physical Therapist CurrentSince Apr 1, 2016 Accepting new patients
Linowski Physical Therapy Physical Therapist PastSince Apr 1, 2016 Accepting new patients

Locations

4323 E Broadway Rd
Ste 106
Mesa, AZ 85206
Phone (480) 854-9833

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609948090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1823 S ESSEX CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852094015",
            "telephone_number": "480-415-0744",
            "fax_number": "480-854-9834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4323 E BROADWAY RD",
            "address_2": "SUITE 106",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063506",
            "telephone_number": "480-854-9833",
            "fax_number": "480-854-9834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "MONTY",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "2989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0297810",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.